@Article{info:doi/10.2196/mhealth.6939,
author="Jongstra, Susan
and Wijsman, Liselotte Willemijn
and Cachucho, Ricardo
and Hoevenaar-Blom, Marieke Peternella
and Mooijaart, Simon Pieter
and Richard, Edo",
title="Cognitive Testing in People at Increased Risk of Dementia Using a Smartphone App: The iVitality Proof-of-Principle Study",
journal="JMIR Mhealth Uhealth",
year="2017",
month="May",
day="25",
volume="5",
number="5",
pages="e68",
keywords="telemedicine; cognition; neuropsychological tests",
abstract="Background: Smartphone-assisted technologies potentially provide the opportunity for large-scale, long-term, repeated monitoring of cognitive functioning at home. Objective: The aim of this proof-of-principle study was to evaluate the feasibility and validity of performing cognitive tests in people at increased risk of dementia using smartphone-based technology during a 6 months follow-up period. Methods: We used the smartphone-based app iVitality to evaluate five cognitive tests based on conventional neuropsychological tests (Memory-Word, Trail Making, Stroop, Reaction Time, and Letter-N-Back) in healthy adults. Feasibility was tested by studying adherence of all participants to perform smartphone-based cognitive tests. Validity was studied by assessing the correlation between conventional neuropsychological tests and smartphone-based cognitive tests and by studying the effect of repeated testing. Results: We included 151 participants (mean age in years=57.3, standard deviation=5.3). Mean adherence to assigned smartphone tests during 6 months was 60{\%} (SD 24.7). There was moderate correlation between the firstly made smartphone-based test and the conventional test for the Stroop test and the Trail Making test with Spearman $\rho$=.3-.5 (P<.001). Correlation increased for both tests when comparing the conventional test with the mean score of all attempts a participant had made, with the highest correlation for Stroop panel 3 ($\rho$=.62, P<.001). Performance on the Stroop and the Trail Making tests improved over time suggesting a learning effect, but the scores on the Letter-N-back, the Memory-Word, and the Reaction Time tests remained stable. Conclusions: Repeated smartphone-assisted cognitive testing is feasible with reasonable adherence and moderate relative validity for the Stroop and the Trail Making tests compared with conventional neuropsychological tests. Smartphone-based cognitive testing seems promising for large-scale data-collection in population studies. ",
issn="2291-5222",
doi="10.2196/mhealth.6939",
url="http://mhealth.jmir.org/2017/5/e68/",
url="https://doi.org/10.2196/mhealth.6939",
url="http://www.ncbi.nlm.nih.gov/pubmed/28546139"
}